A topic that’s come up in almost every discussion we’ve had with health system executive teams and boards recently is workforce strategy. Beyond the immediate political debate about whether temporary unemployment benefits are exacerbating a shortage of workers, there’s a growing recognition that the healthcare workforce is approaching something that looks like a “perfect storm”.
The workforce is mentally and physically exhausted from the pandemic, which has taken a toll both professionally and personally. Many workers are rethinking their work-life balance equations in the wake of a difficult year, during which working conditions and family responsibilities shifted dramatically. That, along with broader economic inflation, is driving demands for higher wages and a more robust set of benefits.
Meanwhile, many health systems are shifting into cost-cutting mode, due to COVID-related shifts in demand patterns and continued downward pressure on reimbursement rates, forcing a renewed focus on workforce productivity.
These combined forces threaten to create a negative spiral, which could lead to even worse shortages and deteriorating workplace engagement. It’s striking how quickly the “hero” narrative has shifted to a “crisis” narrative, and we agree completely with one health system board member who told us recently that workforce strategy is now the number one issue on his agenda.
No easy answers here, but we’ll continue to report on innovative approaches to addressing these difficult challenges.
There’s widespread agreement that it’s important to help older adults and people with disabilities remain independent as long as possible. But are we prepared to do what’s necessary, as a nation, to make this possible?
That’s the challenge President Joe Biden has put forward with his bold proposal to spend $400 billion over eight years on home and community-based services, a major part of his $2 trillion infrastructure plan.
It’s a “historic and profound” opportunity to build a stronger framework of services surrounding vulnerable people who need considerable ongoing assistance, said Ai-jen Poo, director of Caring Across Generations, a national group advocating for older adults, individuals with disabilities, families and caregivers.
It comes as the coronavirus pandemic has wreaked havoc in nursing homes, assisted living facilities and group homes, killing more than 174,000 people and triggering awareness of the need for more long-term care options.
“There’s a much greater understanding now that it is not a good thing to be stuck in long-term care institutions” and that community-based care is an “essential alternative, which the vast majority of people would prefer,” said Ari Ne’eman, senior research associate at Harvard Law School’s Project on Disability.
“The systems we do have are crumbling” due to underfunding and understaffing, and “there has never been a greater opportunity for change than now,” said Katie Smith Sloan, president of LeadingAge, at a recent press conference where the president’s proposal was discussed. LeadingAge is a national association of more than 5,000 nonprofit nursing homes, assisted living centers, senior living communities and home care providers.
“Though this [proposal] is a necessary step to strengthen our long-term care system, politically it will be a challenge,” suggested Joseph Gaugler, a professor at the University of Minnesota’s School of Public Health, who studies long-term care.
Even advocates acknowledge the proposal doesn’t address the full extent of care needed by the nation’s rapidly growing older population. In particular, middle-income seniors won’t qualify directly for programs that would be expanded. They would, however, benefit from a larger, better paid, better trained workforce of aides that help people in their homes — one of the plan’s objectives.
“This [plan] isn’t everything that’s needed, not by any step of the imagination,” Poo said. “What we really want to get to is universal access to long-term care. But that will be a multistep process.”
Understanding what’s at stake is essential as communities across the country and Congress begin discussing Biden’s proposal.
The services in question.Home and community-based services help people who need significant assistance live at home as opposed to nursing homes or group homes.
Services can include home visits from nurses or occupational therapists; assistance with personal care such as eating or bathing; help from case managers; attendance at adult day centers; help with cooking, cleaning and other chores; transportation; and home repairs and modifications. It can also help pay for durable medical equipment such as wheelchairs or oxygen tanks.
The need. At some point, 70% of older adults will require help with dressing, hygiene, moving around, managing finances, taking medications, cooking, housekeeping and other daily needs, usually for two to four years. As the nation’s aging population expands to 74 million in 2030 (the year all baby boomers will have entered older age), that need will expand exponentially.
Younger adults and children with conditions such as cerebral palsy, blindness or intellectual disabilities can similarly require significant assistance.
The burden on families. Currently, 53 million family members provide most of the care that vulnerable seniors and people with disabilities require — without being paid and often at significant financial and emotional cost. According to AARP, family caregivers on average devote about 24 hours a week, to helping loved ones and spend around $7,000 out-of-pocket.
This reflects a sobering reality: Long-term care services are simply too expensive for most individuals and families. According to a survey last year by Genworth, a financial services firm, the hourly cost for a home health aide averages $24. Annually, assisted living centers charge an average $51,600, while a semiprivate room in a nursing home goes for $93,075.
Medicare limitations. Many people assume that Medicare — the nation’s health program for 61 million older adults and people with severe disabilities — will pay for long-term care, including home-based services. But Medicare coverage is extremely limited.
In the community, Medicare covers home health only for older adults and people with severe disabilities who are homebound and need skilled services from nurses and therapists. It does not pay for 24-hour care or care for personal aides or homemakers. In 2018, about 3.4 million Medicare members received home health services.
In nursing homes, Medicare pays only for rehabilitation services for a maximum of 100 days. It does not provide support for long-term stays in nursing homes or assisted living facilities.
Medicaid options. Medicaid — the federal-state health program for 72 million children and adults in low-income households — can be an alternative, but financial eligibility standards are strict and only people with meager incomes and assets qualify.
Medicaid supports two types of long-term care: home and community-based services and those provided in institutions such as nursing homes. But only care in institutions is mandated by the federal government. Home and community-based services are provided at the discretion of the states.
Although all states offer home and community-based services of some kind, there’s enormous variation in the types of services offered, who is served (states can set caps on enrollment) and state spending. Generally, people need to be frail enough to need nursing home care to qualify.
Nationally, 57% of Medicaid’s long-term care budget goes to home and community-based services — $92 billion in the 2018 federal budget year. But half of states still spend twice as much on institutional care as they do on community-based care. And 41 states have waiting lists, totaling nearly 820,000 people, with an average wait of 39 months.
Based on the best information available, between 4 million and 5 million people receive Medicaid-funded home and community-based services — a fraction of those who need care.
Workforce issues. Biden’s proposal doesn’t specify how $400 billion in additional funding would be spent, beyond stating that access to home and community-based care would be expanded and caregivers would receive “a long-overdue raise, stronger benefits, and an opportunity to organize or join a union.”
Caregivers, including nursing assistants and home health and personal care aides, earn $12 an hour, on average. Most are women of color; about one-third of those working for agencies don’t receive health insurance from their employers.
By the end of this decade, an extra 1 million workers will be needed for home-based care — a number of experts believe will be difficult, if not impossible, to reach given poor pay and working conditions.
“We have a choice to keep these poverty-wage jobs or make them good jobs that allow people to take pride in their work while taking care of their families,” said Poo of Caring Across Generations.
Next steps.Biden’s plan leaves out many details. For example: What portion of funding should go to strengthening the workforce? What portion should be devoted to eliminating waiting lists? What amount should be spent on expanding services?
How will inequities of the current system — for instance, the lack of accessible services in rural counties or for people with dementia — be addressed? “We want to see funding to states tied to addressing those inequities,” said Amber Christ, directing attorney of the health team at Justice in Aging, an advocacy organization.
Meanwhile, supporters of the plan suggest it could be just the opening of a major effort to shore up other parts of the safety net. “There are huge gaps in the system for middle-income families that need to be addressed,” said David Certner, AARP’s legislative counsel.
Reforms that should be considered include tax credits for caregivers, expanding Medicare’s home health benefit and removing the requirement that people receiving Medicare home health be homebound, said Christ of Justice in Aging.
”We should be looking more broadly at potential solutions that reach people who have some resources but not enough to pay for these services as well,” she said.
Estimations show that between now and March 20, 7% of U.S. counties will experience “significant strains” on their hospital workforces.
Despite recent declines in coronavirus cases nationwide, many hospitals may still have workforce shortages over the next 30 days due to COVID-19 hospitalizations, according to estimates from George Washington University.
The university’s Fitzhugh Mullan Institute for Health Workforce Equity recently launched its COVID-19 County Workforce Estimator, which predicts that between now and March 20, 7% of U.S. counties will experience “significant strains” on their hospital workforces. It attributes the strain to long-standing staffing problems with the added pressure of the pandemic.
It also predicts that 209 counties will need to implement crisis workforce strategies due to its analysis that ICU doctors in those counties will be forced to take care of 24 or more patients at a time. Hospitals in those locations will likely need to use non-ICU-trained staff to help care for patients, the analysis said.
Further, the tool suggests that 12 counties will need to use contingency workforce strategies that include adding more patients per team, float pools and overtime due to COVID-19 hospitalization rates of 25% or more.
While it estimates a portion of counties will face staffing strains over the next month, the estimator calculated that 2,189 counties will be able to maintain normal workforce strategies due to COVID-19 hospitalization rates of 25% or less.
An additional 736 counties either did not have a hospital or didn’t have enough data to assess potential COVID-19 workforce strains.
The estimator tool was built in collaboration with Premier, a healthcare improvement company, the National Association of County and City Health Officials, and IQVIA, a healthcare data and analytics organization.
WHY THIS MATTERS
Healthcare staffing shortages have been a worry for some time now due to the nation’s increasingly aging population, but COVID-19 has only added to the concern.
Even before the pandemic, studies predicted physician staffing shortages by upwards of 140,000 by 2030, as well as shortages in-home health aides, nursing assistants, nurse practitioners and medical lab technicians by 2025.
Labor experts suggest hospitals develop a proactive response to staff shortages, and the George Washington estimator was designed to do exactly that, according to Clese Erikson, the principal investigator on the project and deputy director of the Health Equity Workforce Research Center.
Local leaders and hospital administrators can use the tool to gauge their county’s ability to care for COVID-19 hospitalized patients and others who need critical care services.
THE LARGER TREND
Outside of the ICU, many hospitals are also experiencing nursing shortages for several reasons, including the possibility that nurses could get $150 an hour to be a traveling nurse versus the $48 an hour they are paid as hospital staff.
In other cases, nurses had to choose between work and having children at home while schools were not holding in-person sessions. Some nurses who were close to retirement chose to leave while others left for work outside of acute care settings.
On top of workforce shortages, the ongoing COVID-19 pandemic has led many healthcare workers to experience strains on their mental health, including anxiety, stress, depression and loneliness.
ON THE RECORD
“The shortages could occur just as public health officials warn that variants of the coronavirus are spreading in the United States and could trigger a sharp rise in the number of Americans infected,” Erikson said.
“Our new online estimator will help county and local public health officials project shortages in the near future and take steps to help keep staffing at safe levels.”
The pandemic put nurses on the front lines of the battle against COVID-19 and caused shifts in the way they provide care.
During this year, nurses have adapted to increased adoption of telehealth and virtual patient monitoring, as well as constantly evolving staffing needs.
These factors — and others, such as the physical and emotional conditions nurses have faced due to the public health crisis — are sure to affect nursing in the years to come. Here, 10 healthcare executives and leaders share their predictions for nursing in the next five years.
Editor’s note: Responses were edited lightly for length and clarity.
Beverly Bokovitz, DNP, RN. Vice President and Chief Nurse Executive of UC Health (Cincinnati): In the next five years, as we continue to encounter a national nursing shortage, I expect to see additional innovative strategies to complement the care provided at the bedside.
One of these strategies will be some type of robot-assisted care. From delivery of medications to answering call lights — and completing simple tasks like needing a blanket or requesting that the heat be adjusted — we will see more electronic solutions. These solutions will allow for a better patient experience and help to exceed the expectations of our patients as customers.
Of course, nothing can take the place of skilled and compassionate bedside care, but many tasks could be automated — and will be — to supplement the professional nursing shortage.
Natalia Cineas, DNP, RN. Senior Vice President and Chief Nurse Executive of NYC Health + Hospitals (New York City): Nurses will continue to play a vital role in addressing the health inequities and social determinants of health among vulnerable populations as the nursing workforce itself becomes more diverse and inclusive. As the largest segment of the healthcare workforce — with some 4 million nurses active in the U.S. — nurses represent the faces of the communities in which they serve. As America becomes a more diverse and inclusive society, so too will the nursing profession become more diverse and inclusive. Currently, industry estimates indicate that between one quarter to one-third of all U.S. nurses identify as a member of a minority group, with between 19 percent and 24 percent of U.S. nurses identifying themselves as Black/African-American; 5 percent to 9 percent identifying themselves as Hispanic; and about 3 percent identifying themselves as Asian. The percentage of minority nurses has been rising steadily for the past two decades and is expected to continue to climb in the coming years.
Blacks and underserved minority populations face numerous genetic, environmental, cultural and socioeconomic factors that account for health disparities, and the impact is particularly visible in the areas of cardiovascular disease, diabetes, pregnancy and childbirth mortality, and cancer outcomes, as well as the enormous toll of the current novel coronavirus global pandemic, where communities of color have been among the hardest hit populations.
In New York City alone, statistics compiled by the city’s health department show Blacks and Hispanics together account for 65 percent of all COVID-19 cases; represented 70 percent of all hospitalizations due to COVID-19; and, sadly, 68 percent of all deaths caused by COVID-19. As demonstrated during this pandemic, in the future, technology such as telehealth and virtual patient monitoring will play a major role in the care of patients. There will be a vast need to address social determinants of health by educating and providing resources to allow utilization of this technology such as using “wearable tech” to monitor ongoing health issues, such as high blood pressure, diabetes, heart conditions and other chronic illnesses.
Ryannon Frederick, MSN, RN. Chief Nursing Officer of Mayo Clinic (Rochester, Minn.):Nursing research will experience extraordinary demand and growth driven by a realization that both complex and unmet patient needs can often be best served by the role of a professional registered nurse. Nurses are uniquely positioned to implement symptom and self-management interventions for patients and their caregivers. Significant disruption in healthcare, including increasing use of technology, will lead to a dramatic shift to understand the role of the RN in improving patient outcomes and implementing interventions using novel approaches. Nursing researchers will provide a scientific body of evidence proving equivalent, if not better, patient care outcomes that can be obtained at a lower cost than traditional models, leading to an even greater demand for the role of the professional nurse in patient care.
Karen Higdon, DNP, RN, Vice President and Chief Nursing Officer of Baptist Health Louisville (Ky.):The value of nursing has never been more apparent. Nurses have led the front line during this pandemic. In the next five years, we must be flexible and creative in establishing new models of care, specifically around roles that support nursing, such as assistant and tech roles. Creating roles with clear role definition, that are attractive and meaningful for nursing support will help build consistent, high-quality models for nursing to lead. This consistency, along with IT capabilities that enhance workflow, will better allow nurses to work at the top of their scope.
Karen Hill, DNP, RN. COO and Chief Nursing Officer of Baptist Health Lexington (Ky.): 2020 was declared the “Year of the Nurse” and this reality has never been more true than realizing the personal and professional sacrifices of nurses in dealing with issues surrounding the pandemic. The next five years will require nursing professionals to be flexible to address new, unknown emerging issues in all settings, to be open to new opportunities for leadership in hospitals, schools and communities and to use technology and telehealth to provide safer care to patients. Nurses need to evaluate our practices and traditions that are value-added and leave behind the task orientation of the past. We need to honor our legacy and create our path.
Therese Hudson-Jinks, MSN, RN. Chief Nursing Officer and Chief Patient Experience Officer at Tufts Medical Center and Tufts Children’s Hospital (Boston):Over the next five years, I expect that the support and retention of clinical nurses will become the top priority of every CNO and executive team, given nurses’ direct impact on supporting the business of healthcare. This will be particularly critical because there will be a concerning shortage of experienced clinical nurses as a result of advancing technologies increasing complexity in care, additional nurse roles created outside traditional areas, fierce competition for talent between large healthcare systems, aging baby boom workforce retiring at higher rates year over year, and a lack of sufficient numbers of PhD-prepared nurses working in academia and supporting higher enrollments.
I also believe that CNOs will be laser-focused on creating the practice environment that enhances retention of top, talented clinical nurses, and we will put a greater emphasis on the influence of effective nursing leadership in reaching that goal. In addition, I fully expect that nurses will be seen more as individuals with talents and experience than ever before — not just a number on a team, but rather a professional with specific, unique, talents that are highly sought after in competitive markets.
Finally, I anticipate that nursing innovation will blossom, given the exposure of the “innovation/solutionist superpower” within nurses during the pandemic. Philanthropy will grow exponentially in support of nursing innovation as a result.
Carol Koeppel-Olsen, MSN, RN. Vice President of Patient Care Services at Abbott Northwestern Hospital (Minneapolis): During the COVID-19 pandemic nurses have been working in difficult physical and emotional conditions, which may lead to significant turnover after the pandemic resolves. Nurses have a commitment to serving others and will persevere until the crisis is past; however, when conditions improve, many nurses may decide to pursue careers outside acute care settings. A possible turnover, coupled with a service economy that has been devastated, may result in large numbers of former service workers seeking stable jobs in nursing. Hospitals will have to be nimble and creative to onboard an influx of new nurses that are not only new to the profession but new to healthcare. Tactics to onboard these new nurses may include the use of retired RNs as mentors, instructor-model clinical groups in the work setting, job shadowing and aptitude testing to determine the best clinical fit.
Jacalyn Liebowitz, DNP, RN. Senior Vice President and System Chief Nurse Officer of Adventist Health (Roseville, Calif.): Over the next five years, I see nurses providing more hospital-based care in the home using remote technology. Based on that shift, we will see lower-acuity patients move into home-based care, and higher-acuity care in hospitals will increase. With that, hospital beds will be used at a different level. My bold prediction is that we will not need as many beds, but we will need higher acute care in the hospitals.
Nurses will learn differently. As we are seeing now, nurses have not been able to train in the traditional way. They are already using more remote technology to educate, onboard and orient to their roles. It looks and feels vastly different, and nurses need to be comfortable with that.
As for patient care, I think data that can be gleaned from wearable biometrics, and the use of artificial intelligence will help predict patient care on a patient-by-patient basis. Nurses will work with AI as part of their thought process, instead of completely focusing on their own judgment and assessment.
I also believe we are going to face a nursing shortage post-COVID for a few reasons. Due to the emotional and physical toll of responding to a pandemic, some nurses will decide to retire, and another group will leave based on the risks that go hand-in-hand with the profession.
As for patient care, we are going to collaborate differently. There will be more video conferencing regarding collaboration around the patient. And I think in the future we will see that the full continuum of care will include a wellness plan.
Debi Pasley, MSN, RN. Senior Vice President Chief Nursing Officer of Christus Health (Irving, Texas):I believe the demand for nurses will become increasingly visible and newsworthy throughout the pandemic. This could drive increases in salaries and numbers of qualified candidates seeking nursing as a profession in the medium and long term. The shortage will, however, continue to be a factor, leading to more remote work options to both supplement nursing at the bedside and substitute for in-person care.
Denise Ray, RN.Chief Nursing Executive of Piedmont Healthcare (Atlanta): Nursing schools will need to focus on emergency management and critical care training utilizing a team nursing model. While nursing has become very specialty-driven, the pandemic has demonstrated gaps in our ability to adapt as quickly utilizing a team model where nurses lead and direct care teams. By implementing a team model and enhancing education in the areas of emergency management and critical care, nursing can adapt quickly to the ever-changing environment.
Also, communication with patients and families will take on different dimensions with wider use of tele-therapeutic communication. Nurses will be leaders and liaisons in the process, connecting physicians, patients and patient families virtually.Nurses will play a key role in integrating patient family members as true patient care partners— making sure they have the information they need to serve an active caregiving role for their family members during and after hospitalization. We’ll also see more nurses becoming advanced nurse practitioners, playing an expanded role in all healthcare settings.
The healthcare sector shed hundreds of thousands of jobs this spring as many providers reduced staffing during the height of the pandemic. Across the summer, healthcare has a seen a wave of rehiring, as doctors’ offices and outpatient surgery and testing centers reopened. But despite the ongoing recession and high unemployment rates, competition for talent remains fierce. In particular, hiring into lower-level clinical support roles is more difficult than before the pandemic, as potential applicants weigh the risk of being exposed to COVID.
In the past, applicants for non-degree positions were attracted by good benefits and a clear career path, but “someone looking to make $15 per hour as an entry-level phlebotomist or patient care associate is now choosing the Amazon warehouse or delivering for DoorDash,” one health executive told us recently. “They’re worried about COVID, and they see the hospital as a place where they’re more likely to get it, even though that’s probably not the case.”
A second health system leader mentioned they have posted hundreds of new job openings in the past two months. According to the COO, “these may be the most important hires we’ve made in decades.” Ensuring this new class of recruits feels safe and supported in the pandemic, and is entering a culture of pride and respect, will lay the foundation for the “post-COVID generation” of the healthcare workforce.
CDC warns the data may not reflect the true scope of the problem, as uneven reporting of confirmed cases likely underestimates the impact.
Healthcare workers who treat patients infected with the COVID-19 coronavirus are at risk of contracting the disease themselves due to frequent exposure and proximity to such patients.
New figures from the U.S. Centers for Disease Control and Prevention detail the extent to which this is true, finding that 9,282 healthcare workers across the country are confirmed to have been infected.
Of those confirmed cases, 27 have died, according to numbers culled from February 12 to April 9. About 55% of all healthcare personnel who were infected only had contact with COVID-19 patients within the healthcare setting.
The vast majority of confirmed positive healthcare workers – 90% – were not hospitalized. Up to 5% of those who were hospitalized ended up in intensive care, while 10 of the 27 deaths were among those workers 65 years old or older.
The CDC warned that the data may not reflect the true scope of the problem, as uneven reporting of confirmed cases across the country has resulted in figures that likely underestimate the number of healthcare workers infected.
WHAT’S THE IMPACT?
The number of coronavirus cases among healthcare workers is expected to rise. While this is due in part to more communities experiencing widespread transmission, the nature of working in the healthcare field understandably contributes to the risk: About 45% of workers who tested positive lived in households or communities in which the virus was present, meaning they risk exposure on two fronts, both inside a healthcare setting and outside of it.
Compounding the problem is that transmission can come from unrecognized sources, including those who are asymptomatic or presymptomatic. Because of that, contact tracing after occupational exposures will likely fail to identify many healthcare workers who are at risk for developing COVID-19.
As with the general population, the higher a healthcare workers’ age, the more likely they were to experience a severe outcome, although severe outcomes – including death – are possible at any age.
Preventative measures meant to staunch the spread among healthcare personnel include screening all workers for fever and respiratory symptoms at the beginning of their shifts, prioritizing such workers for testing, and discouraging working while sick by offering flexible and non-punitive medical leave policies.
The CDC said older healthcare personnel, or those with underlying health conditions, should consult with their healthcare provider and employee health program to better understand their risks. On hospitals’ part, they should consider the enhanced likelihood of severe outcomes among older personnel when mobilizing retired workers to increase surge capacity, especially in light of a shortage of personal protective equipment. One consideration would be preferential assignment of retired workers to lower-risk settings such as telehealth, administrative assignments or clinics for non-COVID-19 patients.
THE LARGER TREND
PPE shortages, insufficient tests, slow results and a dearth of ventilators are all factors that contribute to risk of infection among healthcare workers, and these challenges play off each other in a toxic cycle, an Office of the Inspector General report found last week.
Hospitals said their most significant challenges centered on testing and caring for patients with COVID-19 and keeping staff safe. Severe shortages of testing supplies and extended waits for test results limited hospitals’ ability to monitor the health of patients and staff, and widespread shortages of PPE are putting both groups at risk. Hospitals also said they were not always able to maintain adequate staffing levels or to offer staff adequate support.
Chris Smalls, the employee who helped organize the demonstration, said he felt Amazon had failed to enact adequate measures to protect workers at the facility as many Americans turn to online shopping as stay-at-home mandates expand around the country. Smalls was one of a small group who walked out at a fulfillment center on Staten Island, demanding the company close the site and sanitize it before reopening. He said Amazon had notified employees at the warehouse of one confirmed case of the virus but claimed there were several others that hadn’t yet been reported.
Shortly after the strike, Smalls was terminated after working at Amazon for five years.
“Amazon would rather fire workers than face up to its total failure to do what it should to keep us, our families, and our communities safe,” Smalls said in a statement obtained by HuffPost. “I am outraged and disappointed, but I’m not shocked. As usual, Amazon would rather sweep a problem under the rug than act to keep workers and working communities safe.”
Amazon disputed Smalls’ account in a statement on Monday, saying he had been warned several times for “violating social distancing guidelines” and had been fired after failing to stay home. The company said Smalls’ claims were “simply unfounded.”
“He was also found to have had close contact with a diagnosed associate with a confirmed case of COVID-19 and was asked to remain home with pay for 14 days, which is a measure we’re taking at sites around the world,” a company spokesperson told HuffPost. “Despite that instruction to stay home with pay, he came onsite today, March 30, further putting the teams at risk. This is unacceptable and we have terminated his employment as a result of these multiple safety issues.”
The company also said just 15 employees out of 5,000 at its Staten Island location had participated in the demonstration.
“Our employees are heroes fighting for their communities and helping people get critical items they need in this crisis,” the spokesperson said. “Like all businesses grappling with the ongoing coronavirus pandemic, we are working hard to keep employees safe while serving communities and the most vulnerable.”
The Washington Post notes workers in at least 21 Amazon warehouses and shipping facilities in the U.S. have tested positive for the virus.
Employees at several other major companies staged walkouts on Monday. Workers at Instacart, the grocery delivery company, went on strike nationwide to demand better protections, including hazard pay and expanded paid sick leave. And employees at Whole Foods, owned by Amazon, said they planned to hold a nationwide “sick out” on Tuesday.
Workers at the Staten Island warehouse were first told last week that an employee had tested positive for the novel coronavirus, but they told HuffPost’s Emily Peck that business was “normal” and “running just as it had been” after the declaration. Others said they were afraid of getting sick at work, saying there wasn’t enough protection equipment on site, such as hand sanitizer or masks.
Amazon said it has extended a range of benefits to help protect workers during the pandemic, including extended paid leave options for some employees and increased health and safety measures. Employees diagnosed with COVID-19 are entitled to up to two weeks of paid leave, and Amazon says it notifies workers at sites with infected individuals.
The ongoing efforts by warehouse workers throughout the coronavirus pandemic have garnered support from several lawmakers. Rep. Alexandria Ocasio-Cortez (D-N.Y.) wrote Monday that the employees were simply “demanding dignity.”
“When people work an hourly job, it’s suggested in many ways that you‘re unimportant or expendable,” she wrote on Twitter. “Except you aren’t. Everyone deserves safe work, paid leave, & a living wage.”
When health systems consolidate, one of the major challenges they face is integrating, managing, and optimizing their much larger workforce. The newly integrated workforce must deliver on the value promised by the consolidated enterprise, which is why healthcare industry consolidations need the most advanced workforce solutions available.
The mission of every sector in the consolidation — whether it’s in enhancing the patient experience, improving care quality, realizing economies of scale, expediting the shift from volume- to value-based care, implementing new population health strategies, improving revenue cycle management, or launching new technology — is dependent on the effectiveness of its workforce.
Most healthcare organizations already face workforce problems in the form of shortages of nurses, physicians, technicians and technologists, coders, leaders, and others. Consolidation doesn’t relieve shortage problems, because most organizations’ workforces are already stretched very thin. The paramount challenge may be that the new organization must integrate workforces that have entrenched and often widely different quality standards, procedures, training, values, and cultures. Consistency across the newly consolidated organization must be attained through standardization and adoption of best practices.
Consolidation is producing sophisticated regional enterprises of vertical services and facilities stretching across multiple states, including some emerging as Fortune 500 companies. Solutions to workforce challenges need to become more sophisticated to match this growing organizational complexity. A continuum of effective workforce innovations, many of which have been in use in other industries, are now available in the healthcare industry, though they have been largely untapped until recently.
The talent imperative in healthcare can be effectively addressed through these innovations. Comprehensive managed services programs that optimize the contingent workforce are becoming mainstream. Radical new credentialing innovations can be leveraged to improve time-to-revenue and productivity for physicians and other clinicians. Predictive labor analytics can accurately forecast patient volume months in advance and then match scheduling and staffing practices to the forecasts. Workforce solutions also are available to help find the best talent for leadership roles, which are critically important to guide an industry undergoing fundamental change to revenue based on value instead of volume. The vital realm of health information management is another area where workforce solutions can raise performance in quality, efficiency, and revenue generation.
However, when it comes to workforce solutions, many healthcare organizations remain in a reactive mode, with managers scrambling to fill holes in staffing needs on a daily basis. And many still rely on inadequate paper-based and other outdated systems to manage workforce challenges. Such practices do not fulfill the needs of the sophisticated healthcare organizations emerging from the wave of consolidations. Modern healthcare workforce solutions are needed, but many healthcare organizations don’t have the resources, capacity, or bandwidth to develop and operate these solutions on their own. Or, they are unaware that advanced, technology-enabled workforce solutions are available.
The bright spot is that new entities emerging from consolidations can often leverage combined resources to invest in advanced workforce solutions that will ensure that their enterprise-wide workforce is optimized and performing at its highest level.
Expert workforce partners who are entirely focused on solving healthcare workforce problems hold the key. Such partners are found outside the walls of hospitals and healthcare systems, and the best ones can quickly integrate with patient-care organizations to customize solutions. Since the healthcare workforce is the greatest differentiator in the success of a healthcare enterprise, the services of an expert workforce solutions partner are critical during and after consolidation.